Are you a woman with ADHD considering pregnancy, or a healthcare professional supporting women through this journey? Then you need to know this: The old 'risks vs. no risks' way of thinking about ADHD treatment during pregnancy is outdated and potentially harmful. We need a new approach that weighs all the factors.
Dr. Allison Baker, a leading perinatal psychiatrist, recently shared crucial insights at the APSARD conference about supporting women with ADHD before, during, and after pregnancy. Her message? It's time for a paradigm shift in how we approach treatment decisions.
Dr. Baker, who is double board-certified and affiliated with Massachusetts General Hospital, presented alongside Dr. Katherine Bang-Madsen at the American Professional Society of ADHD and Related Disorders (APSARD) 2026 Annual Conference. Their session focused on the latest research and practical advice for managing ADHD in pregnant and postpartum women. You can find more about the conference here.
Dr. Baker emphasized the prevalence of adult ADHD in women, stating that it affects approximately 3% of women, or about one in 30. She highlighted that many women are diagnosed and treated during their childbearing years. This makes it even more critical to have informed discussions about managing their condition.
The core of Dr. Baker's message is that we need to move away from a simplistic "risks versus no risks" view of treatment. Instead, we must engage in a risk-risk analysis. This means carefully weighing the potential risks of medication exposure – risks that, according to Dr. Baker, are "largely reassuring" based on current reproductive safety data – against the known risks of under-treating or not treating ADHD.
But here's where it gets controversial... Many still believe that any medication during pregnancy is inherently dangerous. Dr. Baker's point challenges this assumption, urging us to consider the potential harm of untreated ADHD on both the mother and the developing child.
What are the risks of not treating ADHD? For the mother, it could mean increased anxiety, depression, difficulty managing daily tasks, and strained relationships. For the child, studies suggest potential links to premature birth, low birth weight, and developmental delays.
And this is the part most people miss: ADHD rarely exists in isolation. Dr. Baker stressed that comorbidity with mood vulnerabilities and anxiety disorders is the norm, not the exception. The postpartum period, with its hormonal shifts, sleep deprivation, and increased demands on executive function, can significantly worsen these co-occurring conditions. This is why planning ahead is so vital.
“This is a clinical population of great importance in terms of the future well-being of patients and families, and also one that is quite high risk,” Dr. Baker stated. She advocates for a comprehensive approach that combines non-pharmacological therapies with medication, if needed, for moderate to severe ADHD. This “winning approach” ensures excellent care for patients. Non-pharmacological therapies can include psychotherapy, coaching, and mindfulness-based interventions. Establishing baselines and taking a holistic view are crucial.
Regarding medication use, Dr. Baker offered clear guidance: “If ADHD pharmacotherapy is required for daily functioning of an individual, it is appropriate to consider and continue in pregnancy.” However, she emphasized that these discussions are best held well in advance of pregnancy. She also recommended a collaborative communication process involving pediatrics, obstetrics and gynecology, and psychotherapists. This collaborative approach ensures the best possible care for both mother and child.
In essence, Dr. Baker is advocating for proactive, informed, and personalized care for women with ADHD during pregnancy and beyond. This includes open communication, careful consideration of all risks and benefits, and a focus on both medication and non-medication approaches.
Dr. Baker's recommendations build upon existing research, including studies on ADHD medication use during the perinatal period and the long-term outcomes of in utero exposure to ADHD medication. These studies, referenced below, contribute to the growing body of evidence supporting informed decision-making in this area.
References:
- Plenary: ADHD and Pregnancy. Presented at the APSARD 2026 Annual Conference (https://www.psychiatrictimes.com/conferences/apsard); January 15-18, 2026; San Diego, CA.
- Bang Madsen K, Bliddal M, Skoglund CB, et al. Attention-Deficit Hyperactivity Disorder (ADHD) Medication Use Trajectories Among Women in the Perinatal Period. CNS Drugs. 2024;38(4):303-314.
- Bang Madsen K, Robakis TK, Liu X, et al. In utero exposure to ADHD medication and long-term offspring outcomes. Mol Psychiatry. 2023;28(4):1739-1746.
Ultimately, Dr. Baker's message is one of empowerment. By providing women with the information and support they need, we can help them make informed decisions about their health and the health of their children.
What do you think? Do you agree with Dr. Baker's emphasis on a risk-risk analysis? Have you experienced challenges in navigating ADHD treatment during pregnancy? Share your thoughts and experiences in the comments below. Let's start a conversation! Is the medical community doing enough to support women with ADHD during pregnancy, or do we need more research and resources?
